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https://www.readbyqxmd.com/read/28625307/postcesarean-delivery-analgesia
#1
REVIEW
Brendan Carvalho, Alexander J Butwick
Effective pain management should be a key priority in women undergoing cesarean delivery. Suboptimal perioperative pain management is associated with chronic pain, greater opioid use, delayed functional recovery, impaired maternal-fetal bonding, and increased postpartum depression. Severe acute postoperative pain is also strongly associated with persistent pain after cesarean delivery. Multimodal analgesia is the core principle for cesarean delivery pain management. The use of neuraxial morphine and opioid-sparing adjuncts such as scheduled nonsteroidal anti-inflammatory medications and acetaminophen is recommended for all women undergoing cesarean delivery with neuraxial anesthesia unless contraindicated...
March 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/28620916/ketamine-does-not-enhance-the-quality-of-recovery-following-laparoscopic-cholecystectomy-a-randomized-controlled-trial
#2
E T Moro, I M P S S Feitosa, R G de Oliveira, G F P Saraiva, R Rosalino, V P Marossi, J A Bloomstone, L H C Navarro
BACKGROUND: Ketamine has been used as part of the multimodal analgesia technique in the acute perioperative period. The effect of perioperative intravenous small-dose ketamine on the quality of recovery from the patient point-of-view has not been assessed. We hypothesized that low-dose ketamine would enhance recovery following laparoscopic cholecystectomy under total intravenous anesthesia. METHODS: One hundred thirty five patients undergoing laparoscopic cholecystectomy were enrolled in this randomized, double-blind placebo-controlled trial...
June 15, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28619696/postoperative-pain-management-in-spanish-hospitals-a-cohort-study-using-the-pain-out-registry
#3
Mauricio Polanco-García, Jaume García-Lopez, Neus Fàbregas, Windfried Meissner, Margarita M Puig
Pain after surgery remains a problem worldwide, though there is no published data on postoperative outcomes in Spain. We evaluated 2922 patients in the first day after surgery in thirteen tertiary care Spanish Hospitals, using the PAIN-OUT questionnaire. Aims were to: assess postoperative outcomes, and anesthetic/analgesic management in orthopedics (ORT) and general (GEN) surgery patients; explore the influence of the analgesic therapy on outcomes and opioid requirements; evaluate and compare outcomes and analgesic management by surgical procedure...
June 12, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/28607342/continuous-regional-anesthesia-a-review-of-perioperative-outcome-benefits
#4
Dario Bugada, Daniela Ghisi, Edward R Mariano
Routine use of regional anesthesia for patients having surgery is supported by general safety and proven effectiveness as a targeted modality in the prevention and treatment of acute pain. Recently, perioperative physicians have become much more interested in improving long-term outcomes after surgery rather than focusing on the well-established short-term benefits of regional anesthesia. This interest has raised important questions regarding the potential influence of regional anesthesia on morbidity and mortality, persistent pain and cancer prognosis...
June 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28591086/dexamethasone-injected-perineurally-is-more-effective-than-administered-intravenously-for-peripheral-nerve-blocks-a-meta-analysis-of-randomized-controlled-trials
#5
Andres Zorrilla-Vaca, Jinlei Li
INTRODUCTION: Peripheral nerve blocks (PNBs) are widely and increasingly used for better acute perioperative pain control for a variety of procedures. Clinically preservative-free dexamethasone is arguably the most commonly used adjuvant and offers the most optimization effects on PNBs yet with the least side-effects noted. Our aim was to compare the effectiveness of intravenous versus perineural dexamethasone on the effectiveness and safety of PNBs. METHODS: Major databases (PubMed, EMBASE, Cochrane library, ISI Web of Science, Google Scholar) were systematically searched for randomized controlled trials (RCTs) comparing the effectiveness of intravenous versus perineural dexamethasone on peripheral nerve blocks...
June 6, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28590258/opioid-induced-hyperalgesia-in-clinical-anesthesia-practice-what-has-remained-from-theoretical-concepts-and-experimental-studies
#6
Lena Weber, David C Yeomans, Alexander Tzabazis
PURPOSE OF REVIEW: This article reviews the phenomenon of opioid-induced hyperalgesia (OIH) and its implications for clinical anesthesia. The goal of this review is to give an update on perioperative prevention and treatment strategies, based on findings in preclinical and clinical research. RECENT FINDINGS: Several systems have been suggested to be involved in the pathophysiology of OIH with a focus on the glutaminergic system. Very recently preclinical data revealed that peripheral μ-opioid receptors (MORs) are key players in the development of OIH and acute opioid tolerance (AOT)...
June 5, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28562485/antihyperalgesic-effect-by-herpes-vector-mediated-knockdown-of-nav1-7-sodium-channels-after-skin-incision
#7
Andreas Eisenried, Michael Klukinov, David C Yeomans, Alexander Z Tzabazis
Postincisional hyperalgesia and allodynia play an important role in perioperative medicine. NaV1.7 sodium channel has proven to be a key player in several pain states, including acute, inflammatory, and neuropathic pain. This study investigated the effects of silencing NaV1.7 through Herpes-based gene therapy with an antisense transcript on pain states after incision of the skin in rodents. Seventy-six Balb/C mice were subdivided into six groups and were treated with no virus, control virus, or NaV1.7 antisense vector before lateral hindpaw skin incision or sham procedure...
May 30, 2017: Neuroreport
https://www.readbyqxmd.com/read/28537508/a-randomized-controlled-trial-for-evaluation-of-lower-abdominal-laparoscopic-cholecystectomy
#8
Li Xu, Haidong Tan, Liguo Liu, Shuang Si, Yongliang Sun, Jia Huang, Manar Atyah, Zhiying Yang
BACKGROUND: To improve minimally invasive outcomes, we designed a new procedure, lower abdominal laparoscopic cholecystectomy (LALC). This study was conducted to evaluate the effects of LALC versus classical (CLC) and single-incision (SILC) laparoscopic cholecystectomy on reducing systemic acute inflammatory response, improving cosmesis, and postoperative pain relief. MATERIAL AND METHODS: Beginning from July 2014, 105 patients meeting the inclusion criteria were randomly assigned to three groups: LALC, CLC, and SILC...
May 24, 2017: Minimally Invasive Therapy & Allied Technologies: MITAT
https://www.readbyqxmd.com/read/28534559/-gastric-volvulus-an-infrequent-cause-of-acute-abdominal-pain
#9
D Ruiz-Clavijo García, A Zuñiga Ripa, L Casanova Ortíz, I García de Eulate Martín-Moro, B González de la Higuera Carnicer, J Urman Fernández
Gastric volvulus (GV) is characterized by the abnormal rotation of a portion of the stomach around a horizontal or vertical axis that can cause obstruction, vascular disorder and even strangulation, and may evolve into necrosis or even perforation. It can be classified according to its aetiology into primary or secondary GV, according to its anatomy into axial organ or into axial mesenteric GV, and according to its presentation into chronic or acute GV. Both types of volvulus require treatment; however, in spite of the classic treatment being open surgery, there is no standard treatment, nor is there consensus on the alternative of choice at present...
April 30, 2017: Anales del Sistema Sanitario de Navarra
https://www.readbyqxmd.com/read/28533693/dna-methylation-at-the-mu-1-opioid-receptor-gene-oprm1-promoter-predicts-preoperative-acute-and-chronic-postsurgical-pain-after-spine-fusion
#10
Vidya Chidambaran, Xue Zhang, Lisa J Martin, Lili Ding, Matthew T Weirauch, Kristie Geisler, Bobbie L Stubbeman, Senthilkumar Sadhasivam, Hong Ji
INTRODUCTION: The perioperative pain experience shows great interindividual variability and is difficult to predict. The mu-1 opioid receptor gene (OPRM1) is known to play an important role in opioid-pain pathways. Since deoxyribonucleic acid (DNA) methylation is a potent repressor of gene expression, DNA methylation was evaluated at the OPRM1 promoter, as a predictor of preoperative, acute, and chronic postsurgical pain (CPSP). METHODS: A prospective observational cohort study was conducted in 133 adolescents with idiopathic scoliosis undergoing spine fusion under standard protocols...
2017: Pharmacogenomics and Personalized Medicine
https://www.readbyqxmd.com/read/28526161/an-update-on-nonopioids-intravenous-or-oral-analgesics-for-perioperative-pain-management
#11
REVIEW
Alan D Kaye, Elyse M Cornett, Erik Helander, Bethany Menard, Eric Hsu, Brendon Hart, Andrew Brunk
Despite an appreciation for many unwanted physiologic effects from inadequate postoperative pain relief, moderate to severe postoperative pain remains commonplace. Although treatment options have evolved in recent years, the use of nonopioid analgesics agents can reduce acute pain-associated morbidity and mortality. This review focuses on the importance of effective postoperative nonopioid analgesic agents, such as acetaminophen, nonsteroidal anti-inflammatory agents, gabapentinoid agents, NMDA antagonists, alpha 2 agonists, and steroids, in opioid sparing and enhancing recovery...
June 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28525409/preserved-analgesia-with-reduction-in-opioids-through-the-use-of-an-acute-pain-protocol-in-enhanced-recovery-after-surgery-for-open-hepatectomy
#12
Michael C Grant, Philip M Sommer, Cathy He, Sylvia Li, Andrew J Page, Alexander B Stone, Deborah Hobson, Elizabeth Wick, Christopher L Wu
BACKGROUND: Enhanced recovery after surgery (ERAS) pathways are designed to restore baseline physiology, mitigate surgical stressors, and hasten recovery. Paramount to this approach is optimal pain control through multimodal analgesia and limiting reliance on opioid-based medications. Recent studies have fostered growing controversy surrounding the use of epidural analgesia in the ERAS setting, especially for higher-risk procedures. We examine the analgesic end points associated with the use of epidural within the ERAS framework for open hepatectomy...
July 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28504322/racial-differences-in-the-pain-management-of-children-recovering-from-anesthesia
#13
Olubukola O Nafiu, Wilson T Chimbira, Margaret Stewart, Kathleen Gibbons, L Kareen Porter, Paul I Reynolds
BACKGROUND: When pain management has been studied in settings such as pediatric emergency departments, racial disparities have been clearly identified. To our knowledge, this has not been studied in the pediatric perioperative setting. We sought to determine whether there are differences based on race in the administration of analgesia to children suffering from pain in the postanesthesia care unit. METHODS: This is a prospective, observational, study of 771 children aged 4-17 years who underwent elective outpatient surgery...
July 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28489787/a-systematic-review-and-meta-analysis-of-intravenous-glucocorticoids-for-acute-pain-following-total-hip-arthroplasty
#14
Xiuhua Li, Zheng Sun, Chengbing Han, Liangliang He, Baoguo Wang
BACKGROUND: Glucocorticoids are increasingly used perioperatively, principally to prevent postoperative nausea and vomiting (PONV), and acute postoperative pain following total hip arthroplasty (THA). The authors hypothesized that preoperative intravenous glucocorticoids is associated with less pain scores and PONV without increasing the complications after THA. METHODS: Four databases (PubMed, Embase, the Cochrane Central Register of Controlled Trials, and Web of Science) were searched with the limitations of randomized controlled trials (RCTs)...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28458575/anesthesia-and-perioperative-pain-management-during-cardiac-electronic-device-implantation
#15
Marina Biocic, Dijana Vidosevic, Matija Boric, Teo Boric, Lovel Giunio, Damir Fabijanic, Livia Puljak
BACKGROUND: The degree of pain caused by the implantation of cardiac electronic devices (CEDs) and the type of anesthesia or perioperative pain management used with the procedure have been insufficiently studied. The aim of this study was to analyze perioperative pain management, as well as intensity and location of pain among patients undergoing implantation of CED, and to compare the practice with published guidelines. PATIENTS AND METHODS: This was a combined retrospective and prospective study conducted at the tertiary hospital, University Hospital Split, Croatia...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28455727/perioperative-considerations-for-patients-with-sickle-cell-disease-a-narrative-review
#16
Narjeet Khurmi, Andrew Gorlin, Lopa Misra
PURPOSE: Approximately 200,000 individuals worldwide are born annually with sickle cell disease (SCD). Regions with the highest rates of SCD include Africa, the Mediterranean, and Asia, where its prevalence is estimated to be 2-6% of the population. An estimated 70,000-100,000 people in the United States have SCD. Due to enhanced newborn screening, a better understanding of this disease, and more aggressive therapy, many sickle cell patients survive into their adult years and present more frequently for surgery...
April 28, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28449696/perioperative-adjuvant-corticosteroids-for-post-operative-analgesia-in-elective-knee-surgery-a-systematic-review
#17
Hasan Raza Mohammad, Marialena Trivella, Thomas W Hamilton, Louise Strickland, David Murray, Hemant Pandit
BACKGROUND: Elective knee surgery is performed to reduce chronic pain and improve function in degenerate knees. Treatment of acute post-operative pain is suboptimal in 75% of patients despite multimodal analgesic approaches resulting in higher post-operative opiate consumption. The effect of corticosteroids as an adjunct for post-operative pain control remains undefined. METHODS: The databases MEDLINE, EMBASE and CENTRAL (Cochrane library) will be searched from their inception to present using broad search criteria for eligible randomised/quasi-randomised controlled trials investigating perioperative corticosteroid adjunctive use in elective knee surgery...
April 27, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28442956/a-comparison-between-intravenous-lidocaine-and-ketamine-on-acute-and-chronic-pain-after-open-nephrectomy-a-prospective-double-blind-randomized-placebo-controlled-study
#18
Ali Jendoubi, Imed Ben Naceur, Abderrazak Bouzouita, Mehdi Trifa, Salma Ghedira, Mohamed Chebil, Mohamed Houissa
BACKGROUND: Recently, there has been increasing interest in the use of analgesic adjuncts such as intravenous (IV) ketamine and lidocaine. OBJECTIVES: To compare the effects of perioperative IV lidocaine and ketamine on morphine requirements, pain scores, quality of recovery, and chronic pain after open nephrectomy. STUDY DESIGN: A prospective, randomized, placebo-controlled, double-blind trial. SETTINGS: The study was conducted in Charles Nicolle University Hospital of Tunis...
April 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28431749/pharmacological-advances-in-the-multimodal-management-of-perioperative-analgesia
#19
M Matute Crespo, A Montero Matamala
The concept of multimodal analgesia is currently widespread in our clinical practice. The aim of multimodal analgesia is to reduce the side effects derived from the drugs or techniques used for the control of pain together with greater effectiveness (combination of multiple mechanisms of action) with the maximum efficiency, that is, to combine different pharmacodynamics (synergistic or additive effects) and pharmacokinetics, in the context of a predictable acute pain model, thus allowing a prior strategy such as the model of acute postoperative pain...
April 18, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28426507/peripartum-anesthetic-management-of-the-opioid-tolerant-or-buprenorphine-suboxone-dependent-patient
#20
Aileen Pan, Mark Zakowski
Opioid abuse and dependence continues to rise in both the general population and pregnancy, with opioid overdose deaths having quadrupled in the last 15 years. Illicit drug use in last 30 days of pregnancy was over 4% with almost 0.6% documented maternal opiate use at time of birth. The management of the opioid-tolerant, buprenorphine-dependent or methadone-dependent patient in the peripartum period is reviewed. Options for treatment of opioid dependence, acute pain management, and perioperative multimodal analgesia are discussed...
June 2017: Clinical Obstetrics and Gynecology
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